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General NPI Number Information
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NPI Number | 1508199969
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Entity Type | Organization
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Legal Business Name | I V S NATH MD FRCP PA
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 6217 66TH ST
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City | PINELLAS PARK
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State | FL
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Zip | 33781-5025
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Country | US
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Telephone | 727-546-1680
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Fax | 727-546-9746
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Provider Business Mailing Address
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Address Line | PO BOX 25233
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City | TAMPA
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State | FL
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Zip | 33622-5233
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Country | US
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Telephone | 727-823-2188
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Fax | 727-828-0723
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Authorized Official
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Title or Position | OWNER
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Name | IYYUNI V S NATH
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Credential | MD
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Telephone | 727-546-1680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME47362
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License Number State | FL
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